Orthotopic heart transplantation (OHT) is a major surgical intervention inducing distress and anxiety. Psychological problems after OHT have been described in many studies. Little is known, however, about ... [more ▼]

Orthotopic heart transplantation (OHT) is a major surgical intervention inducing distress and anxiety. Psychological problems after OHT have been described in many studies. Little is known, however, about the relationship between the psychological state of the patient and time after surgery. The present study involved 41 consecutive OHT patients that underwent transplantation from January 1991 to December 1992, with a retrospective review of pretransplant psychiatric evaluations to define a Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., revised (DSM III-R) Axis I diagnosis. Patients completed the Beck Depression Inventory (BDI-13), Spielberger's State Trait-Anxiety Inventory (STAI-Y), and the General Health Questionnaire (GHQ-28) between 1 and 41 months after transplantation. For comparison, 29 presumably healthy volunteers were given the same questionnaires. The study confirms the occurrence of abnormal psychological scores in the OHT group as compared to the reference population. Psychological scores, however, do not appear to be related to the time they were recorded after surgery. [less ▲]

BACKGROUND: Orthotopic heart transplantation (OHT) is a major surgical intervention inducing distress and anxiety. Psychiatric evaluation of organ transplant candidates is now routinely proposed. This study purposed to assess the psychological evolution in patients having received psychological and/or psychiatric assistance before and during 1-6 postoperative months. METHODS: Twenty-two consecutive transplant candidates were psychically evaluated as part of the preoperative protocol. In the waiting period, 1 and 6 months after OHT, they were asked to fill out the following questionnaires: the General Health Questionnaire, the Spielberger's State-Trait Anxiety Inventory, the Beck Depression Inventory, the Perceived Social Support Scale, the Toronto Alexithymia Scale and the Personal Reaction Inventory. RESULTS: A DSM-IV Axis I diagnosis was found in nine patients (41%); four patients (18%) presented with an Axis II diagnosis. One month after OHT, scores of depression, anxiety and general health significantly improved, while scores of social support, alexithymia and social desirability did not differ. In the sixth postoperative month, all psychological scores remained stable. CONCLUSIONS: A high prevalence of preoperative psychopathology was reported in 22 candidates who received OHT. Surgical intervention obviously improved the quality of life after cardiac transplantation. If the impact of psychological and/or psychiatric aid remains difficult to appraise, these results emphasize the positive impact of surgery on psychological status and the appropriateness of the psychosomatician's social support intervention on patients facing the transplant process. [less ▲]

AB Presents 12 various types of responses to the Rorschach that indicate a distinctive connection with reality that seems to resemble the inability of transsexuals to resign themselves as easily to ... [more ▼]

AB Presents 12 various types of responses to the Rorschach that indicate a distinctive connection with reality that seems to resemble the inability of transsexuals to resign themselves as easily to perceived reality as to symbolic satisfactions (desired reality). The authors then compare the frequency of such responses in the Rorschach protocols of transsexuals and control subject in order to test the validity of this hypothesis. The research to be reported here involved an initial sample of 36 transsexuals, 24 men and 12 women (with the designated sex determined by the original anatomical sex). These subjects had consulted a psychologist for an evaluation that was required prior to a medical decision to perform an anatomical sex-change operation. Clinical observation indicates that transsexuals (a) correctly perceive the anatomical reality of their sex; (b) do not modify their conviction (that of belonging to the other sex) in accord with this perception; and (c) seek to resolve the resulting dissonance by changing their anatomy rather than their conviction (gender identity). On the basis of this observation, we have inferred that transsexuals should maintain a characteristic relationship with reality that we have formulated in terms of indices to be identified during Rorschach testing. [less ▲]

The current main neurochemical theories of the biological correlates of suicidal behavior principally involve the serotonergic system. Few data are available about the possible role of the ... [more ▼]

The current main neurochemical theories of the biological correlates of suicidal behavior principally involve the serotonergic system. Few data are available about the possible role of the catecholaminergic (noradrenergic and dopaminergic) function. In the present study, in a first part, we assessed the growth hormone (GH) response to clonidine, a selective alpha 2-adrenergic agonist, and to apomorphine, a dopaminergic agonist, in 22 DSM-III-R major depressive male inpatients with a history of suicide attempts compared to 22 age-matched major depressive inpatients without history of suicidal behavior. Hormonal responses to clonidine and apomorphine were also compared with 4.00 PM postdexamethasone cortisol levels. The two groups differed significantly in the GH peak response after apomorphine: 6.27 +/- 3.18 ng/ml in suicide attempters vs 17.40 +/- 14.87 ng/ml in nonattempters (F = 11.78, p = 0.001). There was no statistically significant difference between the two groups for GH peak responses after clonidine. Moreover, mean postdexamethasone cortisol levels did not exhibit any significant difference between suicide attempters and nonattempters. Violent and nonviolent attempters did not differ on any of the biological measures. In a second part, P300 and contingent negative variation (CNV) were recorded in 20 depressive inpatients subgrouped into suicide attempters (n = 10) and nonattempters (n = 10). The results showed a significant reduction of both P300 and CNV amplitudes in patients who attempted suicide compared to patients without history of suicide attempts. Moreover, a significant correlation was found between the Suicidal Risk scale and CNV amplitude. In conclusion, these results suggest that a dopaminergic hypoactivity as assessed by a blunted GH response to apomorphine and by a reduction of both P300 and CNV amplitudes, could be considered as a biological correlate of suicidal behavior. In contrast, noradrenergic disturbances, particularly at the level of alpha 2-adrenergic receptors, seem to play a more minor role. Moreover, DST nonsuppression cannot be considered as a biological marker of suicidal behavior. [less ▲]

The prevailing neurochemical theory about biological correlates of suicidal behavior focuses on the serotonergic system. In this study, we assessed the cortisol, ACTH, GH, prolactin and temperature ... [more ▼]

The prevailing neurochemical theory about biological correlates of suicidal behavior focuses on the serotonergic system. In this study, we assessed the cortisol, ACTH, GH, prolactin and temperature responses to flesinoxan, a5-HT1A agonist, in 30 DSM-III-R major depressed inpatients subgrouped into suicide attempters (n = 15) and nonattempters (n = 15). The patients were assessed after a drug-free period of at least 3 weeks. A subsample of 16 patients completed the Buss-Durkee Hostility Inventory as a measure of impulsive aggressive behavior. Mean delta cortisol responses to flesinoxan were significantly lower in the group of depressed patients with a history of suicide attempts than in the group without history of suicidal behavior: for the delta cortisol values 14.5 +/- 16.3 micrograms/l vs 101 +/- 94 micrograms/l (F = 8.9, df = 5.25, p = 0.006). There was also a very significant difference between suicide attempters and nonattempters for the temperature (delta T degrees) responses to flesinoxan: 0.20 +/- 0.24 degrees C vs. 0.60 +/- 0.24 degrees C (F = 18.1, df = 5.25, p = 0.0003). Hormonal and temperature responses to flesinoxan were not correlated with BDHI irritability or assault subscale scores. The results of the present study support the implication of the serotonergic system, particularly 5-HT1A receptors, in the control of self-directed aggressive behavior. Moreover, in depressed patients, serotonergic abnormalities do not appear to be related to aggressive behavior. [less ▲]

The current main neurochemical theories of the biological correlates of suicidal behavior involve serotonergic and, to a lesser extent, dopaminergic systems. Few data are available about the possible ... [more ▼]

The current main neurochemical theories of the biological correlates of suicidal behavior involve serotonergic and, to a lesser extent, dopaminergic systems. Few data are available about the possible implication of the noradrenergic function. In the present study, we assessed the growth hormone response to clonidine, a selective alpha 2-adrenergic agonist, in 15 DSM-III-R major depressive inpatients with a history of suicide attempts, compared with 15 age- and gender-matched major depressive inpatients without a history of suicidal behavior. Mean (+/- SD) growth hormone peak responses to clonidine were significantly lower in the group of suicide attempters than in the control group: 2.93 +/- 3.01 ng/ml vs. 8.28 +/- 8.15 ng/ml. Therefore, these results suggest that a blunted growth hormone response to clonidine could be a biological correlate of suicidal behavior. [less ▲]

Disturbances in dopaminergic neurotransmission seem to play an important role in biochemical mechanisms involved in depressive disorders. The study of the growth hormone (GH) response to apomorphine, a ... [more ▼]

Disturbances in dopaminergic neurotransmission seem to play an important role in biochemical mechanisms involved in depressive disorders. The study of the growth hormone (GH) response to apomorphine, a dopaminergic agonist, provides an indirect index of dopaminergic neurotransmission at the postsynaptic level. In the present study, we assessed the role of the dopaminergic system in some psychopathological dimensions in depression: personality dimensions, suicidal behavior, psychomotor disturbances and dichotomy unipolar/bipolar. Our studies included major depressed inpatients matched for gender, age and, in the case of women, menopausal status. Our results show that dopaminergic disturbances are related to social introversion and anxiety according to dopaminergic hypothesis of schizophrenic disorders and dopaminergic hyperactivity hypothesis of anxiety disorders. A blunted GH response to apomorphine could be considered as a biological marker of suicidal behavior. Moreover motor retardation appeared to be in relationship with dopaminergic disturbances. Finally, the dopaminergic system did not appear to play a significant role in the dichotomy unipolar/bipolar. The results show the interest of the apomorphine test in the assessment of the relationship between biochemical disturbances and clinical correlates. [less ▲]

Assessed the relationships between hypothalamo-pituitary-adrenal (HPA) activity and memory performance using 16 inpatients (mean age 45.9 yrs) with major depressive syndrome and a memory profile developed ... [more ▼]

Assessed the relationships between hypothalamo-pituitary-adrenal (HPA) activity and memory performance using 16 inpatients (mean age 45.9 yrs) with major depressive syndrome and a memory profile developed by A. Rey (1966). Within 2 wks following hospital admission, HPA assessments (both basal and post dexamethasone suppression test [DST] cortisol levels) and the memory profile were administered. Results suggest that HPA assessments including both basal and post-DST cortisol levels are better correlated with memory processes than isolated post-DST levels. [less ▲]

Cytotoxic (M.W.< 1000) and mitogenic (M.W.>10000) soluble factors are released into media conditioned by pure or mixed populations of mouse 3T3 fibroblasts and B16 melanoma cells cutivated in vitro. They ... [more ▼]

Cytotoxic (M.W.< 1000) and mitogenic (M.W.>10000) soluble factors are released into media conditioned by pure or mixed populations of mouse 3T3 fibroblasts and B16 melanoma cells cutivated in vitro. They are generally more active on B16 than on fibroblasts. [less ▲]